The present invention relates to methods and apparatus for use in surgical suturing.
Suture is often used bring two pieces of tissue together and hold the tissues as they heal. Needles allow a surgeon to pierce tissue and pull suture through that tissue. In many procedures, there is adequate space in the wound or incision to manipulate needles and needle holding instruments. The move by surgeons toward less invasive and minimally invasive surgeries has created the need for instruments to be designed to function in limited space and with longer reaches. Standard surgical instruments are being stretched and downsized to pass through tunnels in the tissue called cannulas or portals measuring as small as 5 millimeters in diameter and in a variety of lengths. There is a need for improved surgical instruments to manipulate and control sutures during surgical operations.
The present invention provides new and useful devices and techniques for use in suturing. These devices and techniques are particularly useful in laparoscopic, arthroscopic, and/or open surgical procedures.
One type of suturing device according to the invention is characterized by a handle with an elongated shaft with a sharpened tip configured to hold a suture at a selected point on the suture. Several different types of structures for holding the suture to the sharp tip are provided according to the principles of the invention. For example, one such structure comprises a tapered opening formed in the tip, and configured to enable a suture to be wedged and held in the opening. In another example, an elongated opening is provided, which may be curved, for holding the suture. In yet another example, a locking mechanism is provided, which has a locked position for holding the suture, an unlocked position for releasing the suture, and a partially locked position for controlled adjustment of the suture position relative to the tip.
Another type of device according to the principles of the invention is characterized by new and useful structures and techniques for loading the suture into the device. In one example of this aspect of the present invention, a suture may be side-loaded into the device. This provides numerous advantages, including eliminating the need to thread the suture, and allowing side-release of the suture.
According to still another aspect of the present invention, different shaped suture tips are provided for the selection of the most effective tip shape for a given application. In one example of this aspect of the present invention, each tip may be detached from the suturing device and replaced by another tip. In another example of this aspect of the present invention, the position of each tip is adjustable relative to the shaft of the suturing device for further refinement of the suturing device for a given application.
A suturing device according to the present invention may also be configured for use with a needle point swaged to a suture.
Yet another type of suturing device according to the principles of present invention includes a tissue support structure disposed adjacent the sharpened tip, which may move relative to the sharpened tip to facilitate penetration of the tip through a tissue. In one example of this aspect of the present invention, a suture is carried through the tissue by the tip as the tip penetrates the tissue. In another example of this aspect of the present invention, the tip engages the suture after penetration of the tissue, and draws the suture through the tissue as the tip is withdrawn from the tissue.
A method according to the present invention is characterized by releasably coupling a suture to a suture device, causing the tip of the suture device and a portion of the suture to penetrate a tissue, and releasing the suture from the suture device, so the suture may be drawn through the tissue for completion of a suturing procedure.
These and other features and techniques of the present invention will become further apparent from the following detailed description and the accompanying drawings.